Individual
ALICIA ELMORE
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Mailing address
827 E DIVISION ST, CADILLAC, MI 49601-2015
(231) 775-9741
(231) 775-9333
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
AE015895
MI
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080166353
RAILROAD MEDICARE
MI
01
—
0858317624
BLUE CROSS/SHIELD INDIVID
MI
01
—
0H36303
BLUE CROSS/SHIELD GROUP
MI
01
—
139141
PREFERRED CHOICE
MI
05
—
4621647
—
MI
Enumeration date
08/10/2005
Last updated
12/01/2016
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